Universal catheter securement device

ABSTRACT

A universal securing device for holding catheters of various shapes and sizes and the like in place includes a base and cover. The cover may be connected to the base by a hinge which allows the cover to be lifted open or pushed down into a closed position, over a catheter fitting. The base may have locating elements configured and arranged to fit around catheter fittings of various sizes, and the locating elements prevent substantial movement of a catheter fitting and catheter in various dimensions. The cover may include capture elements which act to grip and compress the catheter fitting when the securing device is in a closed position, thus preventing substantial movement of a catheter fitting and catheter in various dimensions. The base may be attached to a patient with an adhesive pad attached to the bottom surface of the base.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application patent Ser. No.11/622,408, filed Jan. 11, 2007, which claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 60/758,386, filed Jan.12, 2006, and U.S. Provisional Patent Application No. 60/865,095, filedNov. 9, 2006, all of which are hereby expressly incorporated byreference in their entireties.

BACKGROUND

The invention relates to a system for securing a medical device in placeon a patient. Typically, the invention may be used for securing acatheter, tube or other elongated medical device to a patient.

It is often necessary to introduce fluids and liquid medicationsdirectly into a blood vessel of a patient. A simple intravenous (IV)line is usually acceptable for short term general use. IV lines aretypically placed onto a patient's arm and secured with tape. For longerterm and more specialized needs, catheters or other devices are used. Acatheter is essentially a tube inserted through an incision in the skininto a blood vessel in the patient's body, generally without surgery.Peripherally inserted central catheters (PICCs) are frequently used toprovide medications or fluids to home care patients over longer periodsof time. PICCs may also be used for frequent blood sampling.

A PICC line and similar catheters may remain in place in a patient forseveral weeks or months. It is important that movement of the catheterbe minimized. If the catheter is not secured in place, it may beinadvertently displaced from the intended location. Consequently,medication delivered through the PICC line may then be released at anincorrect position within the blood vessel. Repeated back and forthcatheter movement, or pistoning, can cause irritation of the bloodvessel, disrupt proper introduction of medications to the patient, andincrease the potential for bleeding or infection at the catheterincision site. If extensive movement occurs, the PICC line could evencome out of the patient, interrupting delivery of medication andrequiring re-insertion, often with hospitalization.

In the past, catheters were simply taped into place on the patient'sskin. However, taping is time consuming and labor intensive. Tape alsocollects bacteria and must be frequently removed and replaced. Moreimportantly, taping is not necessarily effective in securing a catheterin place. Sutures have also been used to attach a catheter to a patient.With sutures, the catheter is stitched onto the skin. Sutures, however,can also be a source of infection, can cause pain and inflammation, andcan make it more difficult to clean around the incision site. Suturesalso require time and skill to place, and can cause scarring.

More recently, manufactured catheter anchors or securing devices havecome into more widespread use. These devices are specifically designedto secure specific catheters in place. While various designs have beenused, these devices generally have an adhesive-backed pad that bonds tothe skin over a large area. The catheter is secured into or onto acatheter anchor designed for holding the catheter. These anchoringdevices have various advantages over tape or sutures. However,engineering design challenges remain in providing reliable, secure andefficient anchoring devices. Further, because existing anchoring devicesare generally designed for a specific type of catheter, multiple anchorsmay be needed to accommodate use of different types of catheters, e.g.,in hospitals and clinical settings. This adds to the cost and complexityof sourcing, inventory, storage, and selection of the anchoring devices.Accordingly, improved anchoring devices are needed.

SUMMARY OF THE INVENTION

A substantially universal catheter securing device may have a base withone or more locating elements, such as walls or pegs. The locatingelements on the base may be positioned and arranged for securing andpositioning catheters and catheter fittings of various shapes and sizes.The base, which may be attached to an adhesive pad, is connected orconnectable to a cover having capture elements. The capture elements maygrip and compress a catheter fitting when the cover is in a closedposition, thereby helping secure a catheter and catheter fitting ofvarious sizes within the universal catheter securing device. In analternative design, the locating elements can be omitted, with thecatheter secured in the device largely via only compression and frictionforces resulting from clamping the catheter between the base and acover. Another design for holding catheters and the like in place mayinclude locating or positioning elements on a base and contact surfaceson a cover.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, the same element number indicates the same element ineach of the views.

FIG. 1 is an exploded perspective view of a securing device.

FIG. 2 is a top and front perspective view of the device shown in FIG.1, with the cover lifted in an open position and base attached to anadhesive pad.

FIG. 3 is a plan view of the top surface of the base and locatingelements of a securing device shown in FIGS. 1-2.

FIG. 4 is top and front perspective view of the base shown in FIGS. 1-3.

FIG. 5 is a back perspective view showing the bottom surface of the baseshown in FIG. 4.

FIG. 6 is a plan view of the under side of the cover shown in FIGS. 1-2and 5.

FIG. 7 is a top and back perspective view of the under side of the covershown in FIGS. 1-2 and 5.

FIG. 8 is a cross section of a side perspective view of the securingdevice shown in FIGS. 1-2 and 5 in a closed position.

FIG. 9 is a top and front perspective view of the device shown in FIGS.1-2 and 5 in a closed position.

FIG. 10 is a top and front perspective view of another embodiment of asecuring device with the cover lifted in an open position.

FIG. 11 is a top perspective view of the base of the securing deviceshown in FIG. 10.

FIG. 12 is a plan view of the under side of the cover of the securingdevice shown in FIG. 10.

FIG. 13 is a top and back perspective view of the under side of thecover of the securing device shown in FIG. 10.

FIG. 14 is a plan view of the securing device shown in FIG. 10 in theclosed position, holding a catheter fitting representative of variouscatheter fitting shapes and sizes.

FIG. 15 is a top and front perspective view of the securing device shownin FIG. 10 in the closed position, holding an exemplary catheterfitting.

FIG. 16 is a top perspective view of the cover of another embodiment ofa securing device.

FIG. 17 is a perspective view of the under side of the cover shown inFIG. 16.

FIG. 18 is a side view of the cover shown in FIG. 16.

FIG. 19 is a top perspective view of a base for attachment to the coverof FIGS. 16-18.

FIG. 20 is a top and front perspective view of the cover and base shownin FIGS. 16-19 fastened together to form a securing device.

FIG. 21 is a top and front perspective view of a securing deviceattached to a pad.

FIGS. 22-29 are plan views of various catheter fittings positioned onthe base and within the locating elements of the securing devices shownin FIGS. 1-2 and 10.

FIG. 30 is a top plan view of another base for use in a securing device.

FIG. 31 is a top and front perspective view of another embodiment of asecuring device. The pad shown in FIG. 31 is used on each of the varioussecuring devices described below. However, the pad as shown in FIG. 31is omitted from the remaining drawings, to allow for better illustrationof the other components.

FIG. 32 is an exploded perspective view of the device shown in FIG. 31.

FIG. 33 is a top perspective view of the device shown in FIG. 31, withthe cover removed.

FIG. 34 is a plan view of the base shown in FIGS. 32 and 33.

FIG. 35 is a perspective view of the under side of the cover shown inFIGS. 31 and 32.

FIG. 36 is an exploded top and front perspective view of anothersecuring device design useable with another type of catheter.

FIG. 37 is a front view of the device shown in FIG. 36.

FIG. 38 is a front and bottom perspective view of the device shown inFIGS. 36 and 37.

FIG. 39 is a top and side exploded perspective view of another securingdevice design useable with another type of catheter.

FIG. 40 is a top and front view of the device shown in FIG. 39.

FIG. 41 is a top perspective view of the base shown in FIGS. 39 and 40.

FIG. 42 is perspective view of the under side of the cover shown inFIGS. 39 and 40.

FIG. 43 is a top and side exploded perspective view of another securingdevice design useable with another type of catheter.

FIG. 44 is a bottom view of the base shown in FIG. 43.

FIG. 45 is perspective view of the under side of the cover used with thebase shown in FIG. 43.

FIG. 46 is a perspective view of an alternative base, similar to thebase shown in FIG. 43, and having a generally oval shape.

FIG. 47 is a side view of the base shown in FIG. 46.

DETAILED DESCRIPTION OF THE DRAWINGS

A universal securing device for holding catheters of various designs mayinclude a base and a cover. The cover may be connected to the base by ahinge which allows the cover to be lifted open or pushed down into aclosed position, to secure a catheter fitting or similar device. Thebase and/or cover have locating elements configured and arranged to fitaround catheters and catheter fittings of various shapes and sizes. Thecatheter fitting is placed into or onto the base from above. Thelocating elements prevent substantial movement of a catheter and/orcatheter fitting in multiple dimensions.

Latching elements, which may be located on squeezing arms hold the coveronto the base. Capture elements may be located on the under side of thecover to compress a catheter fitting, securely holding it in placeagainst the base, in the closed position. The catheter may be heldsecurely in place on a patient once the securing device is attached tothe patient. The catheter can be removed from the base by disengagingthe latching elements, for example, here by squeezing the squeezing armstoward each other. Thus, a catheter and catheter fitting of variousshapes and sizes can be securely held by a single securing device andcan be quickly and easily attached to or removed from the patient. Thedevices described herein may be used with, e.g., PICC lines, IVcatheters, Foley catheters, heart catheters, J-loops, and variousothers. In addition to a catheter, the present securing device may beused to secure other tubes, cables, wires, and various other medicaldevices as well.

Turning now to the drawings, as shown in FIGS. 1-9, a securing device 20has a base 26. As shown in FIG. 2, the base 26 may be contoured and mayhave one or more locating elements 40 which are shaped and dimensionedto be positioned around and hold catheters and catheter fittings ofvarious shapes and sizes, such as catheter fitting 32 and catheter 30.In FIGS. 2-5 and 8-9, the locating elements 40 include rectangularshaped walls, however, locating elements may be round, square,hexagonal, etc. and they may take on various forms in addition to wallssuch as pegs, columns, etc. The base may vary in size and typically isabout 2-3 inches long and about 1-2 inches wide.

Referring to FIGS. 3-4, the locating elements 40 extend up from the base26. In this particular embodiment, the locating elements include atleast one front wall 41 and a pair of back walls 46. The front and backwalls are spaced apart in a front to back direction as indicated byarrow 49, which runs along a longitudinal axis identified by theimaginary line marked Y shown in FIG. 3. A front wall 41 shown in FIGS.3-4 is made up of at least one curved end wall 42, at least one angledfront wall 43, at least one elbow 44. A semicircular trough 45 may bepositioned slightly forward of the angled front wall 43 as indicated byarrow 49 and may be connected to the elbow 44. A raised post may extendup from at least one elbow 44. The back walls 46 are preferably angledand are each connected to a post 47. The first and second posts 47connected to either back wall 46, can be the same size or they maydiffer in size. In general, the locating elements 40 may besubstantially symmetrical side-to-side about the longitudinal axis orcenterline Y. The locating elements 40 are arranged and positioned toallow PICCs and other catheters of various shapes and sizes to be placedonto the base 26 and held within the securing device 20. The locatingelements 40 are arranged in a manner to help position catheters andcatheter fittings of various shapes and sizes and prevent substantialmovement of a catheter and catheter fitting in various dimensionsrelative to the base, e.g., side-to-side and back-to-front, axialmovement, as well as rotational movement.

Referring to FIGS. 3-4, in one embodiment the locating elements 40 arearranged such that a front wall 41 is separated from the back wall 46 bya dimension AA which extends straight back, parallel to the longitudinalY axis, from the rear most tip of curved end wall 42 of front wall 41 tothe back wall 46. The front wall 41 may also be separated from the backwall 46 by a dimension BB which extends from the rear most tip of curvedend wall 42 of front wall 41, straight back and perpendicular to theback wall 46. Also, the inner edge of the first or left post 47 may beseparated from the inner edge of the second or right post 47 by adimension CC running generally parallel to a lateral axis X. Also, thefirst or left elbow 44 may be separated from the second or right elbow44 by a dimension DD running parallel to dimension CC.

In one embodiment, dimension AA may be less than dimension BB. Also,dimension CC may be greater than dimension DD. In another embodimentdimension AA may measure about 0.34 to 0.38 inches, preferably 0.35 to0.37 inches, or more preferably 0.36 inches in length. Dimension BB maymeasure about 0.37 to 0.41 inches, preferably 0.38 to 0.40 inches, ormore preferably 0.39 inches in length. Also, dimension CC may measureabout 0.35 to 0.39 inches, preferably 0.36 to 0.38 inches, or morepreferably 0.37 inches in length and dimension DD may be about 0.28 to0.32 inches, preferably 0.29 to 0.31 inches, or more preferably 0.30inches in length. In another embodiment, dimension CC may be about 130to 170% of dimension DD or more preferably about 140 to 160% ofdimension DD.

Referring to FIGS. 3-4, the base may also include one or more spikes 48extending up from the base. In one embodiment, a line of posts or spikes48, are located on a line between front wall 41 and back wall 46, onboth sides of axis Y. The line of posts or spikes 48 may be generallyparallel to each other and to the longitudinal axis Y or at an angle of,e.g., 1-45° to the longitudinal axis Y. The spikes 48 may extend up fromthe surface of the base or from capture elements running generallyparallel to each other and to the longitudinal axis Y or at an angle of,e.g., 1-45° to the longitudinal axis Y, on both sides of axis Y betweena front wall 41 and a back wall 46.

Referring to FIG. 1, the base 26 may have two squeezing arms 50 oroptionally the base 26 may have one arm 50 that is resilient andflexible and a second arm 50 which is generally fixed and rigid. Thebase 26 may also have a hinge block 62 located on the base 26 at anopposite end from the squeezing arms 50. The squeezing arms 50 areflexible and have latching elements 52 and sidewalls 57. An angledsurface 56 may be provided at the end 54 of each of the latchingelements 52 facing the inner surface of a squeezing arm wall 57, withgrip ribs 59 on the outside of each squeezing arm wall 57. As shown inFIGS. 3-4, a through hole 66 may be provided, if desired, in the base26, behind the hinge block 62. An arrow symbol 49 may be printed, moldedor otherwise provided on the base 26 and/or the cover 28, running alonga longitudinal Y axis, as shown in FIG. 3. The arrow indicates in whichdirection the catheter should be installed into the universal securingdevice 20.

As shown in FIG. 1, the cover 28 has latch holes 70, and hinge pinholes73 located at opposite ends of the cover 28. Ridges 71, each having anangled surface 72, may optionally be provided below the latch holes 70,as shown, e.g., in the embodiment of FIG. 10. As shown in FIG. 2, thecover 28 is connected to the base 26 by a hinge 60. FIG. 1 shows thatthe hinge may be provided by pressing a hinge pin 75 through hingepinholes 73 and through an aligned hinge pin slot 64 which runs throughthe hinge block 62. The hinge pin 75 may have a round diameter and mayinclude one or more, preferably four, raised crush ribs 77 which serveto hold the hinge pin 75 in place by friction after being press fitthrough the hinge pinholes 73 and hinge pin slot 64. The hinge may alsotake various other forms, for example, a hinge may be formed by tongueand groove elements. A hinge may also be formed by a snap fittingmechanism between a latch or snap hinge and snap hinge base. Varioustypes of hinges or pivot joints may be used. Most designs will have ahinge at one side of the device and a latching element at the otherside, with the cover pivoting open and closed. However, an alternativedesign may have a separate snap on cover having a latch or lock elementat either end of the cover.

As best shown in FIGS. 6-7, the cover 28 includes a first opening 83 ina front wall 84 and a second opening 85 in a back wall 86. The cover 28may have one or more bars 80 which run in a direction DL on theunderside of the cover 28, generally parallel to the lateral X axis. Thecenter area of the bars 80 may be recessed compared to the ends of thebars 80 in order to accommodate the height of various catheter fittings.The bars 80 may be connected by one or more capture elements 82 on theunderside of the cover 28. The capture elements 82 may be generallyparallel to each other and to the longitudinal Y axis, or at an angleof, e.g., 1-45° to the longitudinal axis. The ends of the captureelement 82 may rest at least partially on the surface of the bars 80.One or more posts or spikes 88 may extend from the capture elements 82.In the design shown in FIG. 7, three spikes 88 are spaced evenly apartand extend up from a center elevated segment 86 on the surface of thecapture element 82. Optionally, the capture elements 82 may run alongthe underside of a cover where the cover has no bars.

Turning momentarily to FIG. 2, the capture element 82 is adapted tocontact and compress catheter fittings of various shapes and sizes suchas catheter fitting 32, e.g., by compressing the wings and/or body of acatheter fitting 32 once the catheter fitting 32 is placed onto the base26 within the locating elements 40 and the cover 28 is attached to thebase 26 in a closed position. Capture elements 82 may be solid or springmolded as leaf springs or foam springs. Capture elements 82 may also bean elastomer. The surface of a capture element 82 may optionally beprovided with cones or serrated teeth to assist with compression andgripping of a catheter fitting 32. A single capture element 82 ormultiple capture elements 82 may be used. In the specific design shownif FIG. 2, two capture elements are provided.

Referring again to FIGS. 2 and 4, in use, after the catheter has beeninserted into the patient, the skin at the securement site is preferablycleaned. The catheter fitting 32 is then placed into or onto the base26, within the locating elements 40. The cover 28, which is attached tothe base 26 via the hinge 60, can be closed down, by pivoting about theends of the hinge pin 75 positioned inside the hinge block 62, over andonto the catheter fitting 32. The curved end wall 42, elbow 44 andsemicircular trough 45, all serve to center and align the cover 28 asthe cover 28 is moved down and over the front wall, onto the base 26,and into the closed position. The outside surface of the curved end wall42, elbow 44 and semicircular trough 45 may abut against the innersurface of the front wall 84 of the cover 28 as the cover 28 moves downand into the closed position. Also, a raised post which may be locatedatop one or more elbows 44 may also help align the cover 28 as it closesonto the base 26, and it too may optionally abut against the innersurface of the front wall 84 of the cover 28 as the cover 28 moves downand into the closed position. Also, one or both of the posts 47connected to a back wall 46 may serve to center and align the cover 28as the cover 28 is moved down and over a back wall 46 and the first andsecond posts 47. The first and second posts 47 and back walls 46 mayabut against the inner surface of the cover 28 as the cover 28 movesdown and into the closed position. These alignment features help toproperly locate the cover on the base as the cover is closed.

In a closed position (as shown in FIG. 9), the top end 78 of the cover28 attaches to the base 26 within the squeezing arm walls 57. The latchholes 70 in the front wall 84 and back wall 86 of the cover 28 engagethe latching elements 52 on the squeezing arms 50. This facilitates thesecure attachment of the cover 28 to the base 26, placing the securingdevice 20 in a closed position. The cover 28 rests on the flat andcontoured outer areas of the base 26, around the front wall 41 and backwalls 46 (not shown because enclosed by cover), and on the flat area ofthe squeezing arms 50.

In a closed position, the spikes 88 on one or more capture elements 82may compress down on the wings and/or body of the catheter fitting 32.The wings of the catheter fitting 32, which are generally somewhatflexible or compliant, are thereby pinched or held between the spikes 88of capture element 82 and the spikes 48 extending up from the surface ofthe base 26. The spikes 88 and the spikes 48 are located to grip andcompress the wings and/or body of the catheter fitting. As shown if FIG.8, the spikes 88 and spikes 48 are preferably about 0.04 inches inheight and some vertical space may exist between the tips of the spikes88 and the spikes 48 when the cover 28 is in the closed position. Thespikes 88 may also be slightly offset by 0.02-0.12 inches to the insideof the spikes 48, i.e., toward the arrow 49. The spikes 88 may also besimilarly offset to the front of the spikes 48, as indicated by arrow49. This applies a pinching or bending effect on the wings of thecatheter, in addition to compression. By having the top and bottomspikes offset from each other, the device 20 can better secure cathetershaving wings of varying thickness.

The capture elements 82 thereby secure a catheter fitting 32 withinsecuring device 20 by preventing substantial movement of catheterfitting 32 in an axial, side-to-side, back-to-front, up and down androtational direction. The capture element 82 may be resilient andflexible, capable of holding and griping catheter fittings of variousthicknesses. The capture element 82 may also be solid. The cover 28 maybe used in conjunction with a base 26, having locating elements 40 andspikes 48, for securing a catheter fitting.

In another embodiment, the cover 28 may be used in conjunction with abase 26 for compressing and holding a catheter body on a patient. Thebase may or may not have locating elements. In use, this embodimentwould function by placing a catheter on a base 26 and compressing orpinching the catheter body between an underside surface of a cover 28,e.g., against capture elements 82 or any part of the underside of thecover, and a top surface of the base with sufficient force to hold orrestrain the catheter in place without substantial movement in variousdimensions relative to the base and cover, e.g., axial, side-to-side,back-to-front, up and down and rotational. This arrangement, forcompressing a catheter body of various shapes and sizes between a coverand base could be performed with any of the additional embodimentsdescribed below as well.

Referring again to FIGS. 2 and 4, as the top end 78 of the cover 28 ismoved down onto the base 26 from an open position to a closed position,the angled surfaces 56 on the ends 54 of the latching elements 52 engagethe inner surface of the front wall 84 and back wall 86, below the latchholes 70 on the cover 28. Alternatively, the angled surfaces 56 on theends 54 of the latching elements 52 may engage the angled surfaces 72 ofridges 71, positioned below the latch holes 70 on the cover 28, e.g., asshown in the embodiment of FIG. 10. The latching elements 52 aresomewhat resilient and can flex slightly under load in the longitudinaldirection (along axis Y as shown in FIG. 1). As a result, as the cover28 is moved down into engagement with the base 26, the latching elements52 flex slightly inwardly toward each other. The angled surfaces 56 ofthe latching elements 52 and the inner surface of the front and backwalls 84, 86 below the latch holes 70 on the cover 28 or the angledsurfaces 72 of the ridges 71 slide against each other and pass by eachother. The latching elements 52 then flex back to near their originallongitudinal positions, forcing the ends 54 of the latching elementsthrough the latch holes 70 in the cover 28 and locking the cover 28 ontothe base 26. The catheter securing device 20 is then attached to thepatient at the prepared securement site, usually via an adhesive pad.The securing device 20 then prevents virtually any movement of thecatheter fitting 32 and adjoining catheter 30 within the securingdevice.

The catheter 30 may be removed by squeezing the squeezing arms 50together, towards each other. One or both of the squeezing arms 50 maybe resilient and flexible such that they may flex in the longitudinaldirection. The squeezing arms 50 may be squeezed together by applying aforce in the longitudinal direction, generally on the area of the gripribs 59 located on the outer surface of the squeezing arm walls 57.Squeezing also causes the latching elements 52 on the squeezing arms 50to move longitudinally toward each other, resulting in the ends 54 ofthe latching elements 52 moving back through and out of the latch holes70. The latching elements 52 move toward each other such that the cover28 can be lifted away from the latching elements 52. The angled surface56 and angled surface 72 and/or inner surface of the cover 28 pass byeach other as the cover 28 is pivoted up and off of the base 26.

The securing device described above may be attached to a patient in avariety of ways. As shown in FIG. 1, a base 26 may be attached to a pad162 which is flexible to conform to the patient's arm or other site. Thepad could be a hydro colloidal pad. The specific pad shape and size isnot essential and various alternatives may be used. In FIG. 1, the pad162 is generally oval or round and it can also be a small footprint of abase 26. The back side of the pad 162 preferably has one or morepeelable strips over an adhesive layer or surface. The peel strips maybe removed from the back of the pad 162, and the pad placed onto aprepared securement site. A cut out 164 may be provided at the front ofthe pad 162 to allow the base 26 to be closer to the incision orcatheter entry point. Alternatively, the securing device may be affixeddirectly to a patient by applying adhesive tape around the device andagainst the patient's arm or other site.

FIG. 10 shows another embodiment 90 of a universal securing device.Securing device 90 has a base 96 and a cover 98. In this embodiment, asshown in FIG. 11, the locating elements extending up from the base 96are locating pegs 100 and each peg is surrounded by a ridge 102 at thebase of the peg. A front pair 101 and back pair 103 of locating pegsextend from the base 96 and are arranged in a configuration to positionand hold a catheter and catheter fitting of various shapes and sizes andprevent substantial movement of such catheters and catheter fittings invarious dimensions, similar to locating elements 40 described above.

As with the locating elements 40 shown above in FIG. 3, a first backlocating peg 103 may be separated from a second back locating peg 103 bya dimension CC, while a first front locating peg 101 may be separatedfrom a second front locating peg 101 by a dimension DD, as shown in FIG.11. In one embodiment dimension CC may be greater than dimension DD. Inanother embodiment dimension CC may measure about 0.35 to 0.39 inches,preferably 0.36 to 0.38 inches, or more preferably 0.37 inches in lengthand dimension DD may be about 0.28 to 0.32 inches, preferably 0.29 to0.31 inches, or more preferably 0.30 inches in length. In anotherembodiment, dimension CC may be about 130-170% of dimension DD or morepreferably about 140-160% of dimension DD.

In addition, in FIG. 11, the locating pegs 100 positioned closest to thehinge block 62 and located above the arrow 49, may be connectedgenerally horizontally by a capture element 104. The locating pegs 100located below the arrow 49 and closest to the latching arms 50 may alsobe connected generally horizontally by a capture element 104. Spikes 106may extend up from the surface of the capture elements 104. Asemicircular trough 108, running generally parallel to the lateral axisX of the base 96 and positioned in front of the locating pegs 100 (asindicated by the arrow 49) may also extend up from the base 86. Thespikes may optionally extend up from the surface of the base 86 in anembodiment without capture element 104.

As shown in FIGS. 12-13, the cover 98 includes a first opening 110 in afront wall 114 a and a second opening 112 in a back wall 114 b. As bestshown in FIG. 12 and with reference to the base 96 in FIG. 11, providedon the under side of the cover 98 are locating pegs 100 a which arecapable of fitting inside locating pegs 100 on base 96. The locatingpegs on cover 98 include a front pair 101 a and back pair 103 a oflocating pegs, each with ridges 102 a as well at least one captureelement 104 a running between the locating pegs on the underside of thecover 98 arranged in a configuration that generally mirrors theconfiguration of locating pegs 100 and capture element 104 on the base96. Spikes 106 a may extend up from the capture elements 104 a. Thefront pair 101 a and/or back pair 103 a of locating pegs may bepositioned in between or outside bars 80, which are located on theunderside of the cover 98 and run generally parallel to the lateral Xaxis (shown in FIG. 12). The capture elements 104 and 104 a may bespring molded. Also, if desired, at least one locating peg 100 a may bepositioned at least partially on the surface of a bar 80. At least onecapture element 104 a may also be at least partially positioned on thesurface of a bar 80. Father, with reference to FIG. 10, ridges 71, eachhaving an angled surface 72, may optionally be provided below latchholes 70.

In one embodiment, the locating pegs 100 a on the cover are connected bya capture element 104 a which is positioned at an angle of about 1-45°to a longitudinal Y axis across the underside of the cover 98 andlocating pegs 100 on the base 96 are connected by a capture element 104which is positioned at an angle of about 1-45° to a longitudinal Y axisacross the base.

The securing device 90 shown in FIGS. 10-15 operates in much the sameway as the securing device 20, shown in FIGS. 1-9 and described above.Additionally, as cover 98 closes onto a catheter fitting 116 (or othercatheter fittings of various sizes) which is positioned between thelocating elements and latches onto base 96, locating pegs 100 a mayalign with and engage locating pegs 100 as shown in FIGS. 14-15. Thishelps prevent cover 98 from shifting or moving, making the latchingmechanism between latching elements 52 and latch holes 70 even morereliable. Also, spikes 106 and 106 a are configured and arranged similarto the spikes in the embodiments of FIGS. 1-9 and described above. Thus,spikes 106 and 106 a help compress and grip catheter fittings of variousshapes and sizes such as catheter fitting 32, (e.g., by compressing thebody and/or wings of the catheter fitting) securely holding the catheterfitting 32 in place and preventing substantial movement of the fittingin various dimensions as described above with respect to FIGS. 1-9.

Another embodiment of a securing device 124 is shown in FIGS. 16-20. Asbest shown in FIG. 17, grooves 130 are provided on cover 128 which helpmake the cover more flexible. A latch 132 and snap hinge 136 arecentered at opposite sides of the cover 128, along the lateral X axis ofthe cover 128. Web sections 140 run generally parallel to a longitudinalY axis between column legs 144 and between grooves 130 on the under sideof the cover 128. The web sections 140 include a capture element 142 andelevated ends 145 extending from the web sections 140.

As shown in FIG. 19, the device 124 may also include a base 126. Thelocating elements 150 on the base 126 include a front pair 152 and aback pair 154 of locating elements arranged in a front to back directionas indicated by arrow 49. In general, the locating elements 150 may besubstantially symmetrical side-to-side about the longitudinal axis orcenterline Y. The locating elements 150 help restrain a catheter andcatheter fitting of various shapes and sizes and help preventsubstantial side-to-side, back-to-front, axial and rotational movementof such catheters and catheter fittings on the base 126. At the foot ofa locating element 150 is a ridge 155 and positioned in between thefront pair 152 and back pair 154 of locating elements is a bar 157running on either side of the arrow 49 and generally parallel to arrow49. A bottom latch 159 and snap hinge base 158 are centered at oppositesides of the base 126, along the lateral X axis of the base 126. Sidewalls 156 may extend up form the base along the perimeter of the base126.

In one embodiment the locating elements 150 are arranged such that afront locating element 152 is separated from a back locating element 154by a dimension EE which extends from the inner tip of 152 straight backand perpendicular to 154. Also, the inner edge of the first or rightback locating element 154 may be separated from the inner edge of thesecond or left back locating element 154 by a dimension GG runninggenerally parallel to a lateral axis X. Also, the inner edge of thefirst or right front locating element 152 may be separated from theinner edge of the second or left front locating element 152 by adimension HH running parallel to dimension GG. In one embodiment,dimension GG may be greater than dimension HH. In another embodimentdimension GG may be about 130 to 170% of dimension HH or more preferablyabout 140 to 160% of dimension HH.

As shown in FIG. 20, the device 124 operates such that the cover 128 isattached by the snap hinge 136 to the snap hinge base 158 of base 126and the cover 128 can rotate down onto the base 126 into a closedposition where the latch 132 and bottom latch 159 engage. In a closedposition the capture element 142 on the web sections 140 is adapted tocontact and compress the top of a catheter fitting held within device124. The capture elements 142 help compress and grip catheter fittingsof various shapes and sizes (e.g., by compressing the body and/or wingsof a catheter fitting) securely holding the catheter fitting in placeand preventing substantial movement of the catheter fitting such as inan axial, side-to-side, back-to-front, up and down and rotationaldirection. The capture elements may compress the catheter fittingagainst the ridge 155 and/or bar 157. The ends 145 of the web sections140 serve a similar function as the locating elements discussed above asthey also help restrain a catheter fitting and help prevent substantialside-to-side, back-to-front, axial and rotational movement of thecatheter fitting. The web sections 140 including capture elements 142and ends 145, as well as bars 157 and ridges 155, may be solid or springmolded and may be made of various materials as discussed above.Optionally, a base with no locating elements may be used with the cover128 for compressing and holding a catheter.

FIG. 21 shows securing device 170 having a base 176 and cover 178. Thedevice is attached to an adhesive pad 162. This embodiment operates muchlike the embodiments of FIGS. 16-20 described above for securingcatheters and catheter fittings having various shapes and sizes. Thebase 176 and cover 178 may snap fit together with or without a hingefeature.

FIGS. 22-29 show the universal catheter securement device 20 in use withvarious different types of catheters. With some catheters, as shown inFIGS. 22, 24, 27 and 29, the wings 200 of the catheter 32 are restrainedagainst virtually any longitudinal movement by the front and rearlocating elements. With other catheters, such as shown in FIGS. 23, 26and 28, the wings 200 of the catheter are narrower or smaller, leaving agap between the locating elements. This would nominally allow thecatheter to shift longitudinally under force (e.g., with pulling on thecatheter tubes). However, when the cover is closed, the catheter body202 and/or the wings are clamped tightly by the capture elements. Thislargely prevents any extensive inadvertent and undesirable movement ofthe catheter, even though there may be no direct physical contact with afront or rear locating element.

FIG. 30 shows an alternative embodiment of a base 180 for use in asecuring device. The locating elements 182 on the base 180 include atleast one front wall 183 and a pair of back walls 184 arranged in afront to back direction as indicated by arrow 49. In general, thelocating elements 182 may be substantially symmetrical side-to-sideabout the longitudinal axis or centerline Y and they are arranged toposition and hold catheter and catheter fittings of various shapes andsizes to prevent substantial movement of such catheters and catheterfittings in various dimensions. The front wall 183 may be angled and asemicircular trough 185 may be positioned slightly forward of the frontwall 183 and may be connected to the front wall. The back wall 184 isconnected to a post 186. A bottom latch 187 and snap hinge base 188 arecentered at opposite sides of the base 180, along the lateral X axis ofthe base 180. The base 180 may snap fit to a cover with or without ahinge feature. Side walls 189 may extend up form the base along theperimeter of the base 180 and spikes 190 may extend up from the base andrun in a line on either side of arrow 49, between a front wall 183 andback wall 184. The base 180 can operate in conjunction with a cover in amanner to compress and/or restrain catheters and/or catheter fittings ofvarious shapes and sizes and prevent their substantial movement invarious dimensions.

In one embodiment the locating elements 182 are arranged such that afront wall 183 is separated from a back wall 184 by a dimension JJ whichextends from a mid-point on an inner surface of the front wall 183,straight back and generally parallel to the longitudinal axis Y, to thepost 186. A front wall 183 may also be separated from a back wall 184 bya dimension KK which extends from the outer edge of the front wall 183to the outer edge of the back wall 184. Also, a first or right post 186may be separated from a second or left post 186 by a dimension LLrunning generally parallel to a lateral axis X. Further, a semicirculartrough 185 may have a dimension MM running generally parallel todimension LL. In one embodiment, dimension JJ is greater than dimensionKK. In one embodiment, dimension LL is greater than dimension MM. Inanother embodiment dimension JJ may measure about 0.33 to 0.37 inches,preferably 0.34 to 0.36 inches, or more preferably .35 inches in lengthand dimension KK may measure about 0.31 to 0.35 inches, preferably 0.32to 0.34 inches, or more preferably 0.33 inches in length. Also,dimension LL may measure about 0.41 to 0.45 inches, preferably 0.42 to0.44 inches, or more preferably 0.43 inches in length and dimension MMmay be about 0.15 to 0.19 inches, preferably 0.16 to 0.18 inches, ormore preferably 0.17 inches in length.

In an alternative design, the device may use a generally plane cover andbase, with the device not having locating elements 40 and/or spikes 48.In this design, the cover and base act as simple clamping elements tosecure the catheter. With sufficient clamping force applied, the coverand base can restrain the catheter against significant movement, withoutusing locating elements, such as walls, posts, etc. Force multiplyingelements, such as levers, cams, screw threads, etc. may be used in thistype of design to provide adequate clamping force.

The above securing devices may be molded plastic or made of othermaterials suitable for use with patients. Any of the bases or coversdescribed may be provided in the shapes shown or in other shapes aswell, including irregular shapes. Outer walls extending up from a basearound the outside of the locating elements may also be provided to helpalign and engage a cover onto a base. Also, the various embodiments ofsecuring devices described above may be attached to a patient in avariety of ways, e.g., with a pad as shown in FIG. 2, or with otheradhesive means.

In other embodiments, a securing device for holding catheters and thelike in place advantageously has two parts. A base attached to a padforms one part. A cover is the other part. The cover may optionally betethered to the base. The pad preferably has an adhesive back surfacefor attaching the pad to the patient's skin. The base on the pad haspositioning elements such as walls or surfaces adapted to fit securelyaround a catheter fitting. The catheter fitting may be placed into oronto the base from above. The positioning elements prevent anysubstantial movement of the catheter fitting, in two dimensions,relative to the base or pad, e.g. in the front/back and left/right sidedirections. The cover is attached to the base over the catheter fitting.One or both of the base and cover have latching elements for holding thecover onto the base. The cover prevents movement of the catheter fittingin a third dimension, i.e., vertically up and out of the base.Consequently, after the cover is attached to the base over the catheterfitting, the catheter fitting and the catheter are securely held inplace on the patient. The catheter may be released and removed from thebase by temporarily disengaging the latching elements. The latchingelements may be disengaged by, for example, squeezing the sides of thecover. The catheter can therefore be quickly and easily attached to orremoved from the patient. Such devices may be used with, e.g., PICClines, IV catheters, Foley catheters, heart catheters, J-loops, andvarious other catheters, as well as tubes, cables, lines, and othermedical devices.

For example, FIG. 31 shows an embodiment of a securing device 320 havinga base 326 attached to a pad 322. The pad 322 is flexible to conform tothe patient's arm or other site. The back side of the pad 322 preferablyhas one or more peelable strips over an adhesive layer or surface. Thespecific pad shape and size is not essential and various alternativesmay be used. In the example shown in FIG. 31, the pad 322 generally isoval or round, and with a major diameter of from about 1-6, 2-5 or 3-4inches. The pad does not need any suture holes.

As shown in FIGS. 31-34, a base is attached onto the top side of the pad322 at a generally central location. The base 326 has positioning walls350 shaped and dimensioned to fit securely around a fitting 332 on acatheter 330. For the catheter 330 shown in FIGS. 32 and 33, fourseparate positioning walls 350 are used. In this case, the catheterwalls 350 are adapted to fit around the curved ends of the fittingplate. The walls 350 are spaced apart in the back to front direction(indicated by the arrow 356 in FIG. 32) by a dimension just nominallygreater than the width of the fitting plate 334. Similarly, the walls350 are spaced apart side to side by a dimension nominally greater thanthe length of the fitting plate.

Referring to FIGS. 32-34, outer walls 352 extend up from the base 326around the outside of the positioning walls 350. The outer walls arelower than the positioning walls. Latching arms 340 extend up generallyfrom opposite sides of the base 326. An angled face or surface 344 isprovided at the top or head 342 of each of the arms 340. The base 326may have a tapered or inclined edge or rim 354. One or more throughholes 346 may be provided in the base 326, if desired, for manufacturingpurposes. An arrow symbol 356 may be provided on the base 326 and/or thecover 328, to indicate how the catheter 330 should be installed into thedevice 320.

As shown in FIGS. 32 and 35, the cover 328 has latching arms 366, withan angled surface or face 370 at the outer or lower end 368 of each arm366, similar to the latching arms 340 on the base 326. In the oblongcover 328 shown in FIG. 35, the arms 366 are centered at opposite sidesof the cover, along the major axis of the cover. Web sections 362 runbetween column legs 360 on the bottom or under side of the cover 328.The column legs extend out beyond the latching arms 366. A contact orland surface or area 364 on the web sections 362 are adapted to lightlycontact the top of the catheter fitting 332 when the cover 328 isattached to the base 326.

In use, after the catheter has been placed, the skin at the securementsite is preferably cleaned. The catheter fitting 332 is then placed intoor onto the base 326, as shown in FIG. 33. Land or boss areas 351 may beprovided on the floor of the base 326, within the positioning walls 350,as shown in FIGS. 33 and 33. These areas 351 may be used, if desired, tosupport the catheter fitting 332 off of the floor of the base 326. Thecover 328 is then attached to the base 326 over the fitting 332, asshown in FIG. 31. The outer walls 352 may align with and engage againstinner rim surfaces 365 on the cover 328, as shown in FIG. 35. Thisinteraction, if used, helps to align the cover onto the base, and tosecurely attach the cover to the base. The column legs rest on flatouter areas of the base.

The column legs 360 are dimensioned so that when they bottom out on thebase 326, the contact surfaces 364 rest on the catheter fitting 332. Thelegs 360 prevent crushing or deformation of the catheter fitting, bykeeping the contact surfaces 364 at a specified dimension above the basefloor. As a result, the catheter fitting cannot be crushed, even if thecover is forcefully clamped down onto the base. The fitting 332 issecurely held in place (horizontally) on the base between thepositioning walls and is held in place vertically between the floor ofthe base 326 and the contact surfaces 364 of the cover.

As the cover is moved down onto the base 326, the angled surfaces 344 onthe base latching arms 340 engage the angled surfaces 370 on the coverlatching arms 366. This provides for a cover self aligning operation.The arms 340 and 366 are somewhat resilient and can flex slightly underload in the lateral direction. As a result, as the cover is moved intoengagement with the base, the base latching arms 340 flex slightlyoutwardly, and the cover latching arms flex slightly inwardly. Thesurfaces 344 and 370 of the arms 340 and 366 slide against and then passby each other. The arms 340 and 366 then flex back to near theiroriginal lateral positions, locking the cover 328 onto the base 326. Thepeel strip(s) are removed from the back of the pad 322, and the pad isplaced onto the prepared securement site. The device 320 then preventsvirtually any movement of the catheter fitting 332, which is joined toor part of the catheter 330. A cut out 324 may be provided at the frontof the pad 322 to allow the base 326 to be closer to the incision orcatheter entry point.

The catheter 330 may be removed by squeezing the sides of the cover 328towards each other. The cover 328 is slightly flexible. Squeezing causesthe cover to curve or bow up. As the cover curves, the arms 366 aredrawn inwardly enough to pull the ends 368 of the arms 366 on the cover328 away from the ends 342 of the arms 340 on the base 326. The head orends 342 and 368 can then pass by each other as the cover is lifted offof the base.

FIGS. 36-38 show another embodiment of a securing device 380 for usewith a catheter 390 and catheter fitting 392. The cover 388 has curvedcontact surfaces 364 matching the top of the fitting 392. The base 386has positioning walls 350 adapted to fit around the fitting 392.

FIGS. 39-42 show another embodiment of a securing device 400 for usewith another type of catheter 410 and catheter fitting 412. As shown inFIG. 40, the positioning walls 350 on the base 406 are segmented. Thecover 408, as shown in FIG. 42, includes an opening 416 in a rear wall414.

FIGS. 43-45 show another embodiment of a securing device 430 for usewith yet another type of catheter 440 and catheter fitting 442. In thisdesign, four positioning walls 350 are provided on the base 436. Grooves444 may be provided on the cover 444 to make the cover more flexible. Asshown in FIGS. 41, 43 and 46, ramps or ridges 420 may be provided on thebase floor near or adjoining one or more of the positioning walls 350.These features may be used to set the orientation of the catheterfitting in the device. FIGS. 46 and 47 show a base 450 similar to thebase 436 shown in FIG. 43. The base 450 is generally oval shaped asopposed to the more rectangular base 436 shown in FIG. 43.

The devices shown in FIGS. 36-47 operate in the same way as the device320 shown in FIGS. 31-35 and described above. The base and cover in eachdesign may be molded plastic. The positioning walls 350 may besegmented, as shown in the drawings, or continuous. Indeed, a singlecontinuous positioning wall surrounding the catheter fitting 442 on allsides may be used. Alternatively, multiple short spaced apart wallsegments around two, three or more sides of the fitting may also beused. The wall segments may be various shapes, including generallyrectangular, as shown in FIGS. 45-47, as well as round, square,hexagonal, etc. Positioning or locating elements, such as the walls 350,may optionally also be provided on the cover. Moveable or adjustablepositioning elements or wall segments may also alternatively be providedon the base. If used, these may have a single direction or ratchetfeature, so that they can move only inwardly to contact the sides of thecatheter fitting. Moveable positioning elements may allow use of asingle device with more than one specific type of catheter.

Thus novel devices and methods have been described. Various changes andmodifications may of course be made without departing from the spiritand scope of the invention. The invention, therefore, should not belimited, except to the following claims, and their equivalents.

1. A device for securing a catheter on a patient, comprising: a basehaving one or more locating elements arranged for positioning a catheterfitting; a cover connected to the base by a hinge wherein the cover hasone or more capture elements for compressing a catheter fitting on thebase; and one or more latching elements on a least one of the base orthe cover.
 2. The device of claim 1, wherein the locating elementscomprise at least one front wall separated from at least one back wallin a front to back direction by a dimension AA, which runs parallel to alongitudinal axis of the base straight back from the front wall to theback wall and a dimension BB which runs straight back from the frontwall perpendicular to the back wall, wherein the dimension AA is lessthan the dimension BB.
 3. The device of claim 2, wherein the dimensionAA is about 0.35 to 0.37 inches in length and the dimension BB is about0.38 to 0.40 inches in length.
 4. The device of claim 1, wherein thelocating elements comprise at least one front wall separated from atleast one back wall.
 5. The device of claim 1, wherein the locatingelements comprise a pair of back walls separated by a dimension CC, anda front wall having a pair of elbow pieces separated by a dimension DD,wherein the dimension CC is greater in length than the dimension DD. 6.The device of claim 5, wherein dimension CC is about 0.36 to 0.38 inchesand dimension DD is about 29 to 0.31 inches.
 7. The device of claim 5,wherein dimension CC is 130 to 170% of dimension DD.
 8. The device ofclaim 1, wherein the locating elements are rectangular walls or roundpegs.
 9. The device of claim 1, wherein the base has one or moreflexible squeezing arms and a latching element extends up from eachflexible squeezing arm.
 10. The device of claim 1, wherein the captureelements are positioned along an underside of the cover with one or morespikes extending up from a surface of the capture elements forcompressing a catheter fitting on the base.
 11. The device of claim 10,wherein the base further comprises one or more spikes extending up fromthe base between the locating elements.
 12. The device of claim 10,wherein the capture elements are positioned at an angle of about 1-45°to a longitudinal axis along the underside of the cover.
 13. The deviceof claim 1, wherein the capture element is a leaf spring.
 14. The deviceof claim 1, wherein the capture element is a foam spring.
 15. A devicefor securing a catheter on a patient, comprising: a contoured basehaving at least one locating front wall and two locating back walls forpositioning a catheter fitting, wherein a rear most tip of the frontwall is spaced apart from a back wall in a front to back direction by adimension AA which runs parallel to a longitudinal axis of the basestraight back from the rear most tip of the front wall to the back walland a dimension BB which runs straight back from the rear most tip ofthe front wall perpendicular to the back wall wherein the dimension AAis less than the dimension BB, and one or more spikes extending up fromthe base; a cover connected to the base by a hinge wherein one or morecapture elements are positioned along an underside of the cover with oneor more spikes extending up from a surface of the capture elements forcompressing a catheter fitting between said spikes of the captureelement and the spikes of the base; and one or more flexible squeezingarms on said base with a latching element extending up from saidflexible squeezing arm and engageable in a latch hole located on saidcover.
 16. A device of claim 15, wherein the spikes extending from thecapture elements are slightly offset from the spikes extending up fromthe base when the devise is in a closed position.
 17. A device of claim15, wherein the locating elements comprise a pair of back wallsseparated by a dimension CC, and a front wall having a pair of elbowpieces separated by a dimension DD, wherein the dimension CC is greaterin length than the dimension DD.
 18. A device for securing a catheter ona patient, comprising: a contoured base having two or more pairs oflocating pegs for positioning a catheter fitting, wherein a font pairand back pair of locating pegs are spaced apart in a front to backdirection, the front pair of locating pegs are separated by a dimension,DD, which is less than a dimension, CC, separating the back pair oflocating pegs; a cover connected to the base by a hinge wherein one ormore capture elements are positioned along an underside of the coverwith one or more spikes extending up from a surface of the captureelements for compressing a catheter fitting on the base and two or morepairs of locating pegs which are aligned in a configuration that mirrorsthe front and back pair of locating pegs on said base; and one or moreflexible squeezing arms on said base with a latching element extendingup from said flexible squeezing arm and engageable in a latch holelocated on said cover.
 19. The device of claim 18, wherein the locatingpegs on the cover are connected by a capture element which is positionedat an angle of about 1-45° to a longitudinal axis across the undersideof the cover and locating pegs on the base are connected by a captureelement which is positioned at an angle of about 1-45° to a longitudinalaxis across the base.
 20. The device of claim 19, wherein one or morespikes extend up from a capture element.
 21. The device of claim 18,wherein one or more spikes extend up from the base.
 22. The device ofclaim 18, wherein the capture element is spring molded.
 23. The deviceof claim 1, wherein an adhesive pad is attached to an underside of thebase.
 24. A device for securing a catheter on a patient, comprising: abase; a cover connected to the base by a hinge wherein one or morecapture elements are positioned along the underside of the cover withone or more spikes extending up from a surface of said capture elementsfor compressing a catheter fitting onto said base to secure saidcatheter between said base and said cover without substantial movement;and one or more latching elements on a least one of the base or thecover.
 25. A method of clamping a catheter onto a patient, comprising:attaching a base to a patient; placing a catheter onto said base;compressing said catheter between an underside surface of a coverattached to said base and a top surface of said base with sufficientforce to restrain said catheter in place without substantial movement.26. A universal catheter securement device, comprising: a means forpositioning a catheter; a means for compressing a catheter connected tosaid means for positioning a catheter; a means for detachably couplingsaid means for compressing a catheter to said means for positioning acatheter; and a means for adhering to a patient connected to said meansfor positioning a catheter.
 27. A device for securing a catheter on apatient, comprising: a pad; an adhesive on a second side of the pad; abase on a first side of the pad, with base having one or morepositioning elements for positioning a catheter fitting; a coverengageable onto the base and having one or more contact surfaces forcontacting a catheter fitting on the base; and one or more latchingelements on at least one of the base and cover.
 28. The device of claim27, wherein the positioning elements comprise at least four positioningwalls which are adapted to fit around the catheter fitting, wherein thepositioning walls are spaced apart in a front to back direction by adimension just nominally greater than the width of the catheter fittingand spaced apart side to side by a dimension just nominally greater thanthe length of the catheter fitting.
 29. The device of claim 28, whereinthe contact surfaces are adapted to contact a top surface of thecatheter fitting on the base and wherein said contact surfaces runbetween column legs which extend from an under side of the cover and areadapted to contact flat outer areas of the base thereby keeping thecontact surfaces at a specified dimension above the base and in contactwith the top surface of the catheter fitting.
 30. The device of claim27, further comprising: land areas provided on the base within thepositioning elements, wherein said land areas support the catheterfitting off of a floor of the base.
 31. The device of claim 27, furthercomprising: outer walls extending up from the base and surrounding thepositioning elements wherein the outer walls align with and engage innersurfaces of the cover to align the cover onto the base.
 32. The deviceof claim 27, wherein the base and the cover have at least one latchingelement wherein each latching element is adapted to flexibly engage theother as the cover is moved into locking engagement with the base. 33.The device of claim 27, wherein the cover includes one ore more grovesrunning along a longitudinal axis of the cover for providing flexibilityto the cover.
 34. The device of claim 27, wherein the positioningelements comprise a single continuous positioning wall that surroundsthe catheter fitting on all sides.
 35. The device of claim 27, whereinthe positioning elements comprise multiple short positioning wallsegments that surround two or more sides of the catheter fitting. 36.The device of claim 27, wherein the positioning elements comprisemoveable positioning walls adapted to contact the sides of various typesof catheter fittings.